CALIFORNIA SOCIETY OF PEDIATRIC DENTISTRY
BULLETIN
Spring 2021 | Volume 49 - Number 1
President's Message
State of the Society
PRESIDENT'S MESSAGE
CONNECT. SUPPORT. ADVOCATE.
Dr. Gila Dorostkar - President
I would like to share with you my first ever experience with CSPD.
I vividly remember attending an AAPD conference in Orlando as an out-of-state resident. As I walked down the hall during the Saturday evening cocktail receptions, I peeked into the CSPD reception. The CSPD one was definitely the loudest, most boisterous party in the hotel. People were laughing and having a great time. I wistfully thought to myself “I hope I attend that reception next year and get to be a part of that awesome energy.” Now, here we are over 20 years later. I never imagined that long-ago night the incredible friendships I would make with CSPD colleagues, the generous CSPD mentors who would guide me and the rewarding leadership opportunities I would be able to experience. I am honored and humbled to be president of this organization that I care about so deeply.
We have a fantastic year planned ahead, especially as we slowly ease back into more normal routines post-Covid.
In preparation for the upcoming year, I spoke with CSPD members all across the state. I also distributed a survey to a targeted group of colleagues and friends requesting their feedback about what they thought CSPD’s role should be and its priorities. By far, members responded that CSPD’s role is to advocate for the well-being of children and its members.
Two of the four top reasons why people belong to CSPD have to do with connecting with their colleagues. All California residency program directors expressed the desire to have their residents feel more connected to CSPD throughout the year. In fact, feeling connected to CSPD and other members absolutely resonated as a recurrent theme throughout the surveys and conversations.
I asked members about challenges facing our specialty as well as their own personal challenges. Feeling increasingly stressed and burn-out was one of the top personal challenges.
Based on the many conversations, the survey results and my last three years of experience serving on the Board, I believe CSPD should focus on creating connections among members, supporting members with resources in their clinical and business practices, and advocating for safe, quality dental care for all children.
"We have a wonderful group of people on our CSPD Board this year as well as many dedicated volunteers on our CSPD committees."
One of the ways we can connect our membership that can be implemented right away are the creation of Pop Up Events. Why wait a whole year to see each other in Scottsdale, Arizona for the next Annual Meeting? These small, intimate events will be held throughout the year across the state in different locations and are designed to give members a chance to connect through CE or social activities.
Right out the gate, CSPD has scheduled two different PALS courses this spring in the North and South. As Covid restrictions continue to relax, we will hopefully be able to host more Pop Up Events in person, some will still be on Zoom.
CSPD will focus on current legislative issues that are important for children’s health as well as other issues that will impact our daily practice. There are several key legislative bills that we need to monitor closely and also actively contribute our pediatric dental expertise.
There are plans to introduce programming and events focused for our dental teams. Many members expressed challenges in hiring and retaining staff. Although CSPD can’t necessarily help with hiring, we can definitely assist in providing quality CE for teams that will make team members feel valued and inspired to work in pediatric dental offices.
We will enhance and market our wonderful new Online Continuing Education website. The NonDues Revenue Taskforce will develop a strategic and comprehensive plan to bring in additional revenue that we can reinvest in membership benefits.
CSPD will further increase our communications across a wide variety of social media platforms to strengthen our connections to members and distribute important information.
And, in October 2021, the CSPD Board will dive deep into a Strategic Planning session to ensure CSPD’s processes and structure remain strong and relevant. These are just a few examples of our goals this year. And through it all, we are going to have fun together!
In conclusion, the photo below of the two little girls captures and embodies the spirit of CSPD for me. I see connection, I see support, and I see friendship in this photo and I also see the children of California whom we serve and protect.
I am deeply grateful for the opportunity to serve as your President. We have a wonderful group of people on our CSPD Board this year as well as many dedicated volunteers on our CSPD committees. We will all work hard to make your specialty organization one that you are proud to be a member of and feel a genuine connection with. And we will always continue to keep the best interests of children close to our hearts in everything we do.
MEETING OF THE DENTAL BOARD OF CALIFORNIA
Dr. Paul Reggiardo - Executive Director
The Dental Board of California met virtually by livestream broadcast February 26, 2021. The following report summarizes actions and issues coming before the Board pertinent to pediatric oral health.
ANESTHESIA AND SEDATION PERMITS
Legislation (SB 501 Glazer) signed by the Governor in 2018 and scheduled to become effective January 1, 2022, requires significant change to permitting of General Anesthesia, Conscious Sedation, and Oral Conscious Sedation for Minors in the dental setting. These changes include the introduction of a pediatric endorsement and additional patient monitoring requirements when administering general anesthesia or sedation to a minor dental patient and the creation a new Pediatric Minimal Sedation (PMS) permit. The PMS permit will be required to administer or order the administration of minimal sedation to a patient under 13 years of age. The Dental Board now needs to adopt regulation to implement these changes in law.
1. The current General Anesthesia Permit will be replaced by a Deep Sedation/General Anesthesia Permit with changes in initial application and renewal requirements, development of standards for PALS equivalency training in pediatric dental anesthesia related emergencies, and new monitoring standards for patients under the age of seven years.
2. The current Conscious Sedation Permit will be replaced by a Moderate Sedation Permit with similar changes to application, renewal, PALS equivalency training courses, and monitoring of patients below seven years of age.
3. The current Oral Conscious Sedation Permit for Minors will no longer be issued. It will be replaced by a Pediatric Minimal Sedation Permit with specific monitoring requirements for patients under 13 years of age.
4. The current Oral Conscious Sedation Permit for Adults will remain unchanged and there will be revision to the Medical General Anesthesia Permit required of the physician providing deep sedation or general anesthesia in the dental office.
Comment: The Dental Board expects to receive in May draft language developed by Board staff and legal counsel for regulations sufficient to implement this legislation. It is unlikely the Dental Board will be able to complete the rule-making process in time to meet the January 1, 2022, enactment deadline. In that case, legislation will be sought to extend the enactment date.
STEVEN CHAN APPOINTED TO THE DENTAL BOARD
On April 7, 2021, Governor Gavin Newsom announced the appointment of CSPD and CDA Past-President Dr. Steven Chan to the Dental Board of California. Dr. Chan was previously appointed to the Board in 2016 by then Governor Jerry Brown, serving most recently as Board Vice President until the expiration of his term late last year. His reappointment brings the training, experience, and expertise of a pediatric dental specialist back to the Board’s
decision-making process at a critical time as it adopts the permitting, training, and supervision requirements for sedation in the dental setting scheduled to take effect January 1, 2022. In addition to serving CSPD, AAPD and the California Dental Association in a remarkable number of volunteer positions, he is also a Past-President of the American College of Dentists and has served the children of Alameda County and surrounding communities through clinical practice since 1981.
CSPD congratulates Dr. Chan on his appointment and thanks him for the generosity of his time and for the dedication and commitment it represents to the safety and welfare of the children of California.
SAVE THE DATE!
Our Premiere Virtual Annual Meeting is behind us! Despite the set-backs we encountered through the months and weeks of planning the meeting during the height of the COVID-19 pandemic, we were triumphant in transitioning the originally planned Hybrid meeting to a 100% Virtual venue. Nonetheless, I can proudly say that we realized a successful achievement. I wish to personally acknowledge and thank the entire Annual Meeting Planning committee who worked tirelessly through weekends, taking time away from their families to bring to fruition the first CSPD/WSPD Virtual Experience. Together, we launched an extraordinary event. Over 320 members and non-members were registered and in attendance. Post meeting survey responses were received giving positive ratings to the speaker presentations, pre-recorded poster presentations, and sponsor products and demos.
The CSPD/WSPD 2022 Annual meeting is currently being planned on-site at the luxurious Omni Resort and Spa at Montelucia in Scottsdale, AZ. Surrounded by the spectacular Camelback Mountains and beautiful Red Rocks, it is an ideal destination for adventurous hikers. A preview of our speaker topics include Parental acceptance of Fluoride, Minimally invasive options for Restorative dentistry, Behavior management, Pediatric radiology and oral lesions, Interceptive Orthodontics, Pediatric mental health, and more. Please mark your calendars now and join us.
Dr. Oariona Lowe - Annual Meeting Chair
2021 SPONSORS & EXHIBITORS
THANK YOU TO OUR GENEROUS
TITANIUM SPONSOR
PLATINUM SPONSORS
GOLD SPONSORS
SILVER SPONSORS
EZ FLOSS
KINDER KROWNS
MEDI-CAL DENTAL
PROCTOR & GAMBLE
SPRIG ORAL HEALTH TECHNOLOGIES, INC.
SUNSTAR AMERICAS, INC.
TRELOAR & HEISEL
BRONZE SPONSOR
DOLPHIN IMAGING & MANAGEMENT SOLUTIONS
SHARING A VIRTUAL COFFEE
Dr. Gila Dorostkar - President
A record 24 presidents attended the Past Presidents Breakfast this year held virtually during the Annual Meeting, including two of the founding CSPD presidents, Drs. Weyland Lum and David Good. Although we missed sharing a hot breakfast together, there was definitely an upside with the ease of logging in from just about anywhere to attend. So much so that there is talk about perhaps continuing the Breakfast with a virtual component going forward.
The Past Presidents Advisory Group is an informal advisory panel bringing years of collective wisdom and memory to CSPD. The Breakfast is an opportunity for the Past Presidents to learn about the past year’s activities and accomplishments and also hear the vision and plans for the upcoming year. Each member of the CSPD Executive Committee as well as the CSPD Foundation President, Don Schmitt, presented a progress report. There were also legislative, Bulletin, website, and Annual Meeting updates. It was fun to see our Past Presidents reconnecting with each other and sharing a laugh across the screens.
We value the wisdom that the Past Presidents Advisory Group brings to CSPD and plan to involve this distinguished group of leaders even more throughout the year. They can provide a unique resource of historical knowledge and perspective to current CSPD strategies and decisions. Along with the establishment of an Early Career Pediatric Dentist committee this year (those who have been pediatric dentists for 10 years or less), the Past Presidents will reinforce the remarkable range of member input and insight available to CSPD. This acrossthe-membership engagement keeps our organization strong and relevant. appreciate you and look forward to working with you this year!
STATE OF THE SOCIETY
CSPD - STATE OF THE SOCIETY
The following brief summaries are key reports that were presented at the Past-presidents meeting. CSPD elected leadership shared details about the State of the Society and the issues that will shape the agenda in the year ahead.
WHAT A YEAR!
Dr. Nancy Hsieh - Immediate Past President
President Dr. Nancy Hsieh reported to the group on the State of the Society, reviewing the challenges of 2020, starting with the COVID-19 pandemic just as the Annual Meeting concluded and continuing with the closure of dental practices, disruption of systems of care, shut down of our academic institutions, important cultural movements, California wildfires, and the importance of supporting the mental health of pediatric dental providers and their patient populations. The Society responded to member needs through periodic webinars and the dissemination of patient-related resources. Of particular accomplishment was the launch of an innovative website-based Online Continuing Education platform.
WHAT LIES AHEAD
Dr. Gila Dorostkar - President
President-Elect Dr. Gila Dorostkar presented a vision for the coming year reflecting the findings of a targeted membership survey on challenges facing both the specialty of pediatric dentistry and the personal challenges our members face in private practice and teaching. CSPD will focus this year on creating connections among members, supporting members with resources in their clinical and business practices, and advocating for safe, quality dental care for all children. In addition, CSPD will also emphasize contributing to key legislative issues, designing a comprehensive non-dues revenue plan, and engaging Early Career Pediatric Dentists.
CSPD 2021/2022
SOCIETY FINANCIAL CONDITION
Dr. Donald C. Schmitt - Vice-President
Treasurer Don Schmitt provided a picture of a strong, vibrant, and financially sound organization, in spite of the adverse circumstances posed by the pandemic. CSPD assets continue to increase steadily due to sound financial management and good budgetary planning. While CSPD policy is not to seek profit from the Annual Meeting, which is planned primarily a membership benefit, the annual events have continued to generate income. Going forward, the Society will look at all potential sources of additional non-dues and Online Continuing Education is expected to contribute to this effort.
SOCIETY OPERATIONS
Dr. Paul Reggiardo - Executive Director
The Executive Director recognized the knowledgeable, collaborative, and supportive leadership of CSPD during a demanding year. Dr. Reggiardo conveyed that CSPD is unmatched by any other state chapter of AAPD in the scope, depth, and effectiveness of its membership services and patient advocacy and is in extremely capable hands going forward.
VOICES FOR CHILDREN’S ORAL HEALTH!
Dr. Jacob K. Lee - 43rd CSPD President | 11th AAPD Western District Trustee
Each year during the first week of March, AAPD grassroots advocates make the journey to Capitol Hill to appeal to legislators on issues that address the optimal oral health for children. This year, the pandemic did not deter our efforts. In virtual meetings, 410 AAPD advocates, including 281 pediatric dental residents from 63 residency programs in 41 states and DC, visited 131 congressional offices to meet with members of Congress and their staff.
In California, Pediatric Dental residents from UCLA (8), UCSF (3), USC (3), LLU (1), and NYU Langone SD (1), accompanied by ten program directors and advocacy mentors, visited 14 California congressional offices to call attention to the unmet oral health needs of the children in California and across our nation.
The pediatric dental advocates urged the legislators to co-sponsor the following bills and to actively support the initiatives:
Ensuring Lasting Smiles Act (S. 754/H.R. 1916): Require all private group and individual plans to cover the full medically necessary treatment of patients with congenital anomalies, including related dental procedures.
HRSA Title VII Pediatric Dentistry Appropriations and Dental Faculty Loan Repayment Program (S. 449/H.R. 1285): Provide FY 2022 funding not less than $14 million for Pediatric Dentistry Training program and make the DFLRP non-taxable to recipients.
Access to Operating Rooms for Pediatric Dentists: Contact the Centers for Medicare and Medicaid Services and ask the agency to move forward ensuring that dental rehabilitative services be provided to children, including those with special health care needs. Ask CMS to set up a new billing code for use by hospitals and ambulatory surgery centers.
AAPD’s goal is to continue to recruit and cultivate impassioned pediatric dentists as grassroots advocates who will entreat legislators to support bills that provide for children’s optimal oral health. It is AAPD’s fervent hope that the pediatric dental residents remain vociferous advocates for children’s oral health in their respective districts as we continue to build the United States of Pediatric Dentistry!
Now the time has come for me to say goodbye. This is my final report as your Western District Trustee. It has been a tremendous honor to serve you. I have strived to serve as a conduit of communication and activities by enhancing the collaborative efforts between the AAPD and the Western District Chapters. My special gratitude is extended to you, the CSPD members, who inspired and encouraged me during my tenure.
UCLA pediatric dental residents in a virtual meeting with Ms. Faith Williams, the legislative assistant to Congressman Mike Levin. Mr. Levin represents Dr. Lee’s 49th congressional district.
HIGHLIGHTED BOARD MEMBER
Dr. Amber Nierode - CSPD Director North FEATURED ARTICLE
My maternal grandmother immigrated to CA from the Azores islands of Portugal in search of the American Dream. My Dad also came from the Azores islands and immigrated to CA when he was 18 years old. Most of my family members were unable to receive a formal education while growing up in the Azores. Since my Dad couldn’t read or write in English, job opportunities were very limited to him. Nevertheless, he has proudly worked hard to provide for his family every day in the same factory since his arrival in Los Angeles in 1984. My Mom was a housekeeper and I grew up helping her clean homes not because I had to, but because I wanted to help her arrive home earlier and spend time with our family. My Mom eventually transitioned to owning her own day care business when I was older. My work ethic undoubtedly stems from the work values my parents and grandparents have instilled in me. I became the first college graduate in my family and the only family member to have a postgraduate degree. It was incredibly difficult to be the first to navigate a professional career. I often felt that I was alone in the endeavor, but I wasn’t. I was lucky enough to have incredible mentors who helped guide me on my path. I wouldn’t be where I am today without them. A few of those mentors are fellow CSPD members.
I graduated from residency in 2017 and currently work at Santa Rosa Pediatric Dentistry. My position at Santa Rosa Pediatric Dentistry has been an integral part of my career. Through this practice, I’ve gained a new set of mentors to help light my path and help me reach my next set of goals as a pediatric dentist.
I accepted the position of Director North because I envision a diverse CSPD board and believe I can offer insights and perspectives that many of our early career
pediatric dentists share. I also greatly value the expertise and knowledge of our mid and later career pediatric dentists. This opportunity to learn from and work with the most talented members in our field is invaluable to me. I believe the future of CSPD is incredibly bright. Our president, Dr. Dorostkar, has hit the ground running through her efforts to find out what members want and need. I’m especially looking forward to meeting fellow early career dentists at meet-ups set up by the CSPD! One of the greatest aspects of CSPD is the comradery and support it provides.
Dr. Kim Nichelini and my first CSPD Annual Meeting are the reasons why I decided to join organized dentistry. While I was at the Annual Meeting I was able to meet so many incredibly awesome and inspiring people. Not only are our members intelligent and dedicated, but they know how to have a good time! That annual meeting was one of the most fun meetings I’ve been to. It was there that I realized organized dentistry is more fun than it sounds! At the meeting, I was able to meet the former CSPD president, Dr. Suzy Tavana. Dr. Tavana explained in all seriousness that she is a dedicated Pitbull the rapper fan. She was so approachable and kind, it was during this moment that I realized organized dentistry is not a group of intimidating and stuffy leaders (these were my thoughts in dental school!). Organized dentistry is composed of people like you and me, all wanting to come together for the greater good of our profession and the kids we serve.
The start of the pandemic was a serious struggle for me. I had just closed on a house during the same week as the shutdown. I feared I would no longer be able to make my new house, car, and student loan payments. The fear of the unknown and how long the shutdown would last is what challenged me the most. Ultimately, our practice still flourished and performed better than it has since I started practicing there.
If there was a prize for the “most TV shows and movies binge-watched by a pediatric dentist”, then I think I would win. My guilty pleasure is staying up way too late bingewatching Netflix! Some of my favorite recent shows are The Queen’s Gambit (my all-time favorite Netflix series – highly recommended!), Ginny and Georgia, and The Crown.
LEGISLATIVE BILLS OF INTEREST
Dr. Natalie Mansour - Public Policy Advocate
AB 454 (Rodriguez): Health care provider emergency payments
Summary: The bill would give state regulators the authority to require medical and dental plans and insurers to support their contracted provider network through various means such as grants, increased rates or payments for mandatory infection control measures like PPE during a future public health emergency.
CSPD: SUPPORT
Comment: Physician and dental practices have struggled financially during the COVID-19 pandemic. Medical and dental plans and insurers are making profits during a public health emergency by taking in premiums but paying less as patients are not seeking regular care. Dental practices are seeing less patients and are incurring costs due to new infection control procedures.
AB 526 (Wood): Dentists: clinical laboratories: vaccines
Summary: Allows dentists to independently prescribe and provide the influenza and Covid-19 vaccines to Children 3 or older. This bill would expand the definition of “laboratory director” to include a duly licensed dentist serving as the director of a laboratory that performs only authorized clinical laboratory tests.
CSPD: SUPPORT
Comment: This bill is being co-sponsored by the California Dental Association. This bill will allow dentists to allow point of care Covid rapid test to patients. They have the scope to do this on a national level but state regulations do not delineate that dentists can do this. This bill creates harmony with federal and state laws in order to get lab licenses for rapid Covid testing.
The second part of the bill is codifying the DCA waiver that allows dentists to administer Covid and flu vaccine for 3 and over. It will allow CDC courses that were taken for the requirements for the DCA waivers to be retroactively accounted for, and going forward count for license renewal. The CDC is not a registered CE provider, but this bill will allow it to be considered an acceptable version of CE.
AB 733 (Chiu): Dental Hygienists: registered dental hygienists in alternative practice
Summary: This legislation would expand access to oral health care for children enrolled in Medi-Cal and pregnant people by allowing registered dental hygienists in alternative practice to partner with medical professionals in medical settings to provide fluoride and oral health education to coordinate care with dental providers and the dental care system.
CSPD: WATCH
Comment: This bill will keep the scope of practice for RDHAPs the same, but will change the current settings in which an RDHAP will practice. There will be no restrictions on settings. Current settings include residences of the homebound, schools, residential facilities and other institutions and medical settings that a residential facility patient has been transferred to for outpatient services, dental health professional shortage areas, as certified by the Office of Statewide Health Planning and Development in accordance with existing office guidelines, and dental offices. This bill does not define how the coordination of care will occur to ensure a dental home.
AB 1163 (Nazarian): Local government: taxation: prohibition: groceries
Summary: This bill would repeal the prohibition on the imposition, increase, levy and collection, or enforcement by a local agency of any tax, fee, or other assessment on groceries, including the requirement that the department cease administering a local sales and use tax.
CSPD: SUPPORT
Comment: Consumption of Sugary drinks leads to risk of diabetes, heart disease, stroke, and tooth decay. Massive quantities of sugar are added to these drinks. Revenue from taxes can generate funding towards community efforts to improve local health equity conditions impacted by the consumption of sugary drinks and fund critical services.
AB 1552 (Garcia): Dentistry: foreign dental schools: application
Summary: This bill would require previously approved foreign dental schools to complete the CODA accreditation by January 1, 2030 in order to remain approved.
CSPD: WATCH
Comment: As of January 21, 2020, the board no longer accepts applications for schools seeking approval as a foreign dental school and shall require the applicant to complete the international consultative and accreditation process with the commission on dental accreditation (CODA) of the American Dental Association (ADA).
SB 652 (Bates): Dentistry: use of sedation: training
Summary: This bill defines what the training requirements will be for General Anesthesia and Moderate Sedation.
CSPD: WATCH
Comment: This bill defines what the training will be for patients 13 years of age and under vs 13 years of age and older in regards to general anesthesia and moderate sedation. The existing new permit laws will go into effect January 1, 2022.
CSPD follows a number of bills under consideration by the state legislature which potentially impact pediatric oral health. Members having questions or wishing to comment on these or any other legislative matters are invited to contact CSPD’s Public Policy Advocate, Dr. Natalie Mansour, at natalie.usc.trojan@gmail.com
FACULTY SPOTLIGHT
Dr. Alexander Alcaraz - Program Director of Pediatric Dentistry at USC
Its crazy to think how uncertain things were for all of us at the start of the pandemic. In academics we had just shut down clinical operations and were trying to navigate the virtual learning world. There were many times I had feelings of uncertainty and confusion. How were we going to graduate our residents on time? How were we going to ensure the safety of our team? These were some of the many questions I was contemplating. At the start of the shutdown, I remember receiving a phone call from the Dean of USC, Dr. Avishai Sadan. Seeing his name on my phone, I thought the worse and assumed something bad had happened. To my surprise, he was delivering great news and offering me the position of Director of the Advanced Education Program in Pediatric Dentistry at USC. I remember feeling a little numb with this information and wondering how l would be able to manage all the job responsibilities especially during the pandemic. Fast forward a year to now and I feel so grateful for all the people who have given me an opportunity to serve in this capacity.
There are many factors that have guided me in my journey to becoming program director. I grew up in Garden Grove, CA where my parents still live. My parents were elementary school teachers who instilled in me a strong work ethic and an appreciation for learning through curiosity. I went on to receive my Bachelors of Biological Sciences at University of California, Irvine and then felt the urge to explore a new environment. Feeling inspired by the movie Good Will Hunting I was happy to be accepted to Harvard School of Dental Medicine where I enjoyed an incredible education in an amazing place to live. However, the winters were too cold for my Southern California blood. I yearned for returning home and received my pediatric specialty certificate at USC under the direction of Dr. Richard Udin. After graduating residency, I went into private practice. I worked in several offices where the managing doctors were incredibly gifted as pediatric dentists and compassionate with how they treated me as an associate dentist. I used those first years after I graduated like a fellowship, where I took notes regularly on best practices in clinical management. I consider these colleagues my close friends and still practice a day a week with Dr. Eddie So in Monrovia, CA.
Although I enjoyed private practice, I felt my family roots in education telling me I needed to teach. At the beginning I wanted to ‘only teach one day a week’, but quickly realized teaching was my passion. With each year I taught, I became more enamored with academics and eventually accepted a full-time position teaching at both USC and Children’s Hospital Los Angeles. At CHLA I was able to apply the medical training I received at Harvard and treat children who were medically compromised. I also was able to learn from the director at CHLA, Dr. Jose Polido, how to lead a team of staff and attendings.
Through my teaching experience. I realized that helping a resident learn was inspiring for me. I enjoyed the challenge of helping the residents develop critical thinking skills essential to being a pediatric dentist. Then came the opportunity to further my academic career after the retirement of Dr. Udin. I am grateful to Dr. Udin and the incredibly strong program he had developed. Not only would he train me as a resident and as an academician, but he also served as the example for how to be leader in our profession. I am appreciative for his support and mentorship, as well as all our faculty at USC who have encouraged me during this transition.
I would like to acknowledge the incredible support given to our residency program by both CSPD and the CSPD Foundation. These organizations have been critical to our success and will continue to be as we move forward to train the next generations of pediatric dentists. I look forward to both the future of our program and the future of pediatric dentistry. I believe our role in academics is to not only train great pediatric dentists but also form excellent leaders in the community and profession. My goal for this program is to maintain the strong didactic/clinical training our residents have always received and nurture their growth in overall wellbeing that is critical to their future career success. I look forward to the future years at USC and accomplishing these goals.
CSPD’S VIRTUAL ANNUAL MEETING AND OCE DURING THIS PANDEMIC
Dr. Steven Niethamer - Website Editor
The recent survey sent to CSPD members confirms that most of our members get their CE credits from either CSPD or AAPD annual meetings. The intent is that CE is important to keep our members up to date in our profession. It is also required to renew dental licenses and permits by the Dental Board of California
The 2021 CSPD/WSPD Annual Meeting was a virtual meeting. What does this mean for Continuing Education Credits (CEUs)? The following are some actual Q&As we received about continuing education for pediatric dentists in California:
Question: I would like to virtually “attend” CSPD’s annual meeting, but have a question. Will I need to watch the program as it is being presented? Or, once registered, will I be able to stream the presentations later in the weekend? I am scheduled to work that Friday and am also on call for our office, so will not be able to watch some of the presentations in real time.
Answer: The answer is dictated by §1017 of the California Code of Regulations governing the continuing dental education requirements for licensure and permit renewals. Specifically, the Board dictates that at least 50% of required CEUs be by live instruction. Courses may be provided digitally but must include “live interactive course study” to be accepted as “live” and not a “correspondence course.”
Courses attended virtually at the 2021 CSPD/WSPD annual session were given as --- and qualify as --- live instruction by the Dental Board of California. As such, attendance at each lecture was verified electronically by the Pathable platform and, after completing the meeting survey, attendees were emailed CEU certificates by CSPD. Each of the live courses was attended as it was presented in real time – along with opportunities for interaction by attendees with the instructor through the platform “chat” feature. Remember that registrants must have signed into the live virtual lecture and completed the post meeting survey before the certificates were provided to attendees.
For about 6 months following this meeting, the lectures will be available to annual meeting attendees as recorded presentations on the CSPD OCE website. Registrants of this annual meeting will be given special
coupon codes that provide access to view the meeting’s programs without having to pay additional fees. By using CSPD’s OCE platform, any of the meeting registrants who missed attending a program or want to review a program more carefully, can have access to the lecture again. If CEUs are desired, following the successful completion of a short quiz, they will be issued as continuing education credit for “correspondence course” instruction. The certificate will necessarily carry a different CA course number than that issued for the “live instruction” provided at the meeting. In this manner, we comply with the requirements of the Dental Board, preserve the flavor and experience of an actual meeting, and still make the continuing education available afterward to attendees without additional cost.
Question: Has the Dental Board temporarily relaxed any of these "live" instruction requirements due to COVID and the accompanying restrictions on attendance?
Answer: The answer is a little complicated. In September the Director of the Department of Consumer Affairs issued a directive under the Governor’s March 4, 2020, proclaimed State of Emergency seeming to waive Dental Board regulation that automatically disqualified “as a live course” any CE using a recorded lecture even if a live speaker was present, despite the fact that the interaction attendees experience would be essentially the same as a fully-live webinar. This had always been the interpretation of most CE providers (but evidently not that of the Board). With the waiver in place, it is now explicitly clear that recorded lectures count as live CE so long as there is the ability to have meaningful live interaction with the course presenter throughout the offering. This allows streaming of pre-recorded lectures with speaker/attendee interaction through the chat function of a virtual presentation. None of this, however, changes or relaxes the requirement that no more that 50% of required units necessary for license renewal may be other than live presentations. Our courses on-site or livestreamed will qualify as live CE. Our courses subsequently available as recorded presentations will still be considered “correspondence” continuing education by the Dental Board.
Question: Will our attendees earn the credit they need to renew their oral sedation certificates by viewing this year’s annual meeting sedation courses virtually? Do a portion of those courses need to be "live" in order to earn credit towards the certificate?
Answer: As to qualification for renewal of the Oral Conscious Sedation permit, our courses about sedation, whether attended live or recorded, will meet the Board’s criteria so long as no more that 50% of the total number of units (hours) required for renewal of the dental license are other than live instruction.
2020-2021 ANNUAL GIVING CAMPAIGN DONORS
Ann Azama & Randy Lee
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DIAMOND LIFE
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CORPORATE LIFE
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MENTAL HEALTH & WELLBEING OF PEDIATRIC DENTISTS
PART 2: BUILDING RESILIENCE & DAILY TOOLS FOR WELLBEING
Dr. Shivani Keshav, Warren Brandli Leadership Intern
Part 1 of this series discussed the stressors that exist in the lives of pediatric dentists. It is likely that many of us strive to be perfectionist when dealing with our professional and personal lives. We need to recognize that perfectionism is a destructive cycle. When we try to be perfect all the time, we will find ourselves trying to overcompensate feelings of inadequacy.
To combat the need to be a perfectionist, focus on self compassion. Dr. Kristin Neff has developed the "3 elements of self compassion" which allow us to process and respond to situations in a mindful way.
Self- compassion will allow you to practice the same kindness to yourself that you would to others around you.
When stressful situations arrive, we can easily become frustrated if we feel overwhelmed by the inability to handle a situation immediately. In other words, we often hope to be resilient when dealing with these situations. Resilience is essentially how you bounce back from stress. We cannot expect ourselves to become resilient to situations immediately -- instead we have to give ourselves time to process what is happening. For some people it may take days, weeks, months or even years. Resilience is a skill that each of us develop over the course of our lives through individualized experiences.
There are many simple ways to prioritize and improve our wellbeing. Figure out which aspect of your life can be most improved, such as exercise/activity, hobbies/interests, or support systems and start there. Find a way to incorporate a few techniques into your daily routine.
A technique that I learned of recently and have found helpful is called "Three Good Things." The steps are simple:
1. Think of 3 good things that happened today.
2. Write it down.
3. Reflect on your role in why they happened.
This exercise is allows for the positive things to short circuit our natural tendency to concentrate on the negative. Studies have found that doing this over the course of a few months has the same effect as taking Prozac in improving the wellbeing of people. It was replicated for healthcare workers and studies found there was not only an overall improvement in communication and attitude amongst team members, but also in their personal lives. This can be a helpful activity to incorporate in your practice.
I hope you each find ways to practice self-compassion and healthy habits so that you can continue to give the best version of yourself to your professional and personal life.
SPRING AWAKENINGS
Dr. Jonathon Lee - Past President
Spring is the season of new beginnings. Buds freshly bloom, animals awaken, and the earth seems to come to life again after being dormant during the winter. Behind the scenes, organized dentistry at the State, District, and National Levels worked hard ensuring that the profession would be ready for its reemergence in a post COVID-19 world. CSPD adapted under the leadership of President Nancy Hsieh. Thank You, Nancy, and CSPD for guiding us through these unprecedented times. Thank you to Outgoing WSPD President Cody Hughes and Outgoing Western District Trustee Jacob Lee.
At the National Level, The AAPD Communications Committee updated three of its Patient Education Brochures: The Pediatric Dentist, Dental Care for Your Baby, and Sealants. The committee also advocated that the AAPD Membership and patients would benefit from a Patient Brochure on Dental Insurance to help educate the public on dental Insurance. The AAPD Board of Trustees at its 2021 Winter Board Meeting authorized this brochure’s commissioning.
On December 22nd, 2020, the ADA and the AAPD achieved a long-time legislative priority when the U.S. Senate voted to repeal the McCarran-Ferguson antitrust exemption for health insurance companies by passing HR 1418, the Competitive Health Insurance Reform Act. The House previously passed the bill on September 21st, 2020. The President signed the bill into law on January 13th, 2021.
The profession of dentistry is at a turning point where an active and engaged membership and responsive leadership are more important than ever. The pandemic has given us time to pause and reflect on our future and life balance. It has shown the resilience and adaptability of the human spirit.
The pandemic has also taken a mental toll. Sarah Lyall writes about this in her April 3rd, 2021, The New York Times Article, We Have All Hit a Wall, Confronting late-stage pandemic burnout, with everything from edibles to Exodus. https://www.nytimes.com/2021/04/03/business/pandemic-burnout-productivity. html
“When people are under a long period of chronic, unpredictable stress, they develop behavioral anhedonia,” Dr. Wehrenberg said, meaning the loss of the ability to take pleasure in their activities. “And so they get lethargic, and they show a lack of interest — and obviously that plays a huge role in productivity.”
She writes, “Call it a late-pandemic crisis of productivity, of will, of enthusiasm, of purpose. Call it a bout of existential work-related ennui provoked partly by the realization that sitting in the same chair in the same room staring at the same computer for 12 straight months (and counting!) has left many of us feeling like burned-out husks, dimwitted approximations of our once-productive selves.”
“Malaise, burnout, depression and stress — all of those are up considerably,” said Todd Katz, executive vice president and head of group benefits at MetLife. The company’s most recent Employee Benefit Trends Study, conducted in December and January, found that workers across the board felt markedly worse than they did last April.
Yes, malaise, burnout and depression, and stress are up. Recognition that we are all in the same boat is the first step in tearing down that mental wall. Moving forward, we must tackle this mental wall. We must be engaged members communicating with our leaders. We must guide the future path of pediatric dentistry as a profession because we pediatric dental specialists are the experts in pediatric dentistry.
Fortunately, CSPD and WSPD have an activist/advocate leadership under the guidance of newly installed President Gila Dorostkar and incoming WSPD President Dennis Nutter. Having worked with them, I know they will break down that wall and guide the profession in the right direction at the State and the District levels, making practice and academics exciting and fulfilling. Gila and Dennis have demonstrated a reputation of listening to members and serving the membership and the public by advocating optimal oral health of infants, children, and adolescents.
I look forward to serving with them and you in representing CSPD and the Western District at the National level. Thank you, it is a privilege to be your Incoming Westering District Trustee. Make it a happy healthy day.
ROBIN THE ROBOT
A state-of-the-art innovation in pediatric dentistry
Designed for children by scientists, engineers, and pediatric psychologists, Robin is the first emotionally intelligent robot used in pediatric dentistry. Standing at 47 inches tall, Robin's cur ved body shape with smooth transitions along the edges of the frame ensures safe use and high levels of excitability
Robin utilizes peer-to-peer interactions, engages children in various active distraction techniques such as interactive games, visual and auditor y sensor y modalities, including images and music, and age-appropriate conversations to decrease their stress related to dental procedures. Conducted studies showed that after the interaction with Robin, children's joyfulness level increased by more than 26%, and stress reduced by 34%, resulting in a 40% decrease in the time of medical procedure preparation due to better cooperation with the dentists.
TECHNOLOGY THAT BRINGS VALUE
Amid the COVID-19 pandemic, when almost ever y child support method is prohibited, Robin becomes a reliable tool to meet children's emotional needs. Robin's cutting-edge technology not only improves patient access to care but also helps dental practices provide a better patient experience. The clinics that use Robin leverage it in nonclinical areas as well, such as increased retention rates, attracting new customers, and improved social media presence due to increased patient satisfaction.
Robin is also a great educational tool in pediatric dentistr y. With its educational content, Robin increases children's knowledge about various dental procedures, coping strategies, and healthy behaviors, which influences each child's overall health. Robin also teaches children about dental hygiene, including correct brushing techniques, schedules, and foods to avoid for having better oral hygiene. Robin also prepares children for dental treatment by explaining procedures in a fun and simple way using various animations. In turn, understanding dental tools and treatment steps decreases children's stress and anxiety and supports them to better cooperate with the clinic's personnel.
For more information visit https://www.expper.tech or reach out to us at info@expper.tech.
+1 (415) 851-2583
ON THE LINE
Dr. Steve Chan, Past President
Giving the shot – is just one link - in a supply chain.
I live in Fremont, California - home of the Tesla electric car manufacturing plant.
To build cars – it’s bringing lots of parts to one place –and the human processes to put the parts together. There’s a lot of moving parts that must move in synchrony – to deliver the end product.
I was – on the supply chain line - giving the COVID vaccine shots – at our regional hospital’s mass vaccination events. But just standing back, watching all the moving parts in play – I could imagineorchestrating and managing this event – is staggering. And there are so many processes – that we couldn’t see.
By the first week of February, the Governor signed an emergency waiver of restrictions - to allow California dentists to administer the vaccine. Required was completion of a three CDC online courses: COVID Vaccine training, the Pfizer vaccine, and the Moderna vaccine.
I happen to be the longest serving dentist on Washington Hospital’s Medical Staff in Fremont. This regional hospital serves a tri-city/southern portion of Alameda County in the San Francisco Bay Area. Central is Fremont, the fourth largest city in the Bay Area. The hospital service area includes some 370,000 people.
Thru a serpentine maze of orange cones – the cars progressed thru a series of checkpoints by volunteers. There’s a lot of “paperwork” to be processed. At the head of this snake - the cars are diverted into four administration stations or tents –for the injections. This is where I came in.
In mass events, it’s moving a lot of people. Buzz words like time motion, economy of motion, and repetitive motion come into play. In each of the four injection lines, there can be as many as 10 cars – sometimes carrying multiple patients. Each tent may have two vaccine administrators.
The actual act of injecting is pretty prosaic.
One physician on the line said, “As a dentist, you do more shots in a day than I do in my career!”
But break down the steps. Each step takes finite time. Add up those nanoseconds. More cars are getting into your line.
Sanitize hands. Don gloves. Open Band Aid packet to cover injection site. Open alcohol wipe.
Verify syringe: Time expiration, volume content, secure needle onto syringe. (We had to learn the mechanics of 3 different types of safety needles/syringes)
In our hospital system, the first dose is managed Monday through Friday in an on-campus indoor auditorium. At the time of this writing, priority to receive the vaccine was based on Tier 1 qualifications –essential workers and over 65.
Tracking - from receiving the vaccine – to placing the syringe in the hand of the vaccinator, then add - all the tracking of patients and product – gets complicated. People have to move the processes. The supply chain is more than those 10 cc vials.
The second dose follow up is performed in a massive drive thru Saturday and Sunday event. A huge parking lot in front of a three story commercial building is the setting. The organizers anticipate a caravan of 1000 cars for each weekend event. They are ramping up for more.
Verify patient. Verify label on syringe to patient tracking document, sign document.
Quiz patient: Ask for reactions (...more that Ouch?) from first dose or allergic response - to determine length of post injection monitoring before releasing patient. Remember, this is new for each patient.
Identify anatomic landmark. Alcohol wipe. Inject. Band Aid placed. Post injection instructions. Retract needles. Dump needles, glove, wipes. Start all over again – for each patient.
I asked a volunteer to time us. At the peak, there’s a 3-4 minute turnaround time from glove to glove. Face to face patient turnaround time: including the injections40 seconds.
What was fascinating – was seeing a slice of life in our community. 99% were appreciative. I did get insulted a couple of times. As one car pulled up – before I could even say anything – I was asked: “Do you know what you’re doing?
I was dressed appropriately in scrubs and PPE. Luckily, I’m in a profession where someone knows how to suture my tongue. In a four hour shift, time was a blur...and I had “miles I to go before I sleep...”
Epilogue
I came out of the closely guarded bubble of my immediate family. I came out of the well-protected bubble of the practice.
The Chinese word for “Crisis”...is composed of two calligraphy characters. The characters are “danger”...and “opportunity”.
Danger has been in our face - for the past 12 months.The waiver offered an opportunity.
The choice? Stay in the Bubbles? Or...do however small part - to curb COVID in my community. Stopping COVID - is on the line.
VIRTUAL BOARD OF DIRECTOR'S MEETING - MARCH 18 & 20, 2021
BOARD MOTIONS
MOTION: 2021.03.18.05 (SABBADINI): Move that the current ad hoc Non-Dues Revenue Committee be dissolved as it has fulfilled its charge and a new NonDues Revenue Committee be formed at the direction of the CSPD President to continue to focus on proposing and implementing coordinated strategies to generate non-dues revenue from the sale of products, services, and programs to members, sponsors, vendors and nonmember dentists. MOTION CARRIED
MOTION: 2021.03.18.06 (SCHMITT): Move to keep the current dates of March 18-24, 2024, for the 2024 Annual Meeting. MOTION CARRIED
MOTION: 2021.03.18.07 (SCHMITT): Move CSPD approve a position of support of AB 1163 and AB 526 and that CSPD take a position of watch on AB 733, AB 1552, and SB 652. MOTION CARRIED
MOTION: 2021.03.18.08 (GUIJON): Move to withdraw the following motion “removal of the Peer Review Committee as a standing CSPD committee” that is to be voted upon at the CSPD 2021 Business Meeting. MOTION CARRIED
MOTION 2021.03.20.21.01 (TANBONLIONG): Move to approve the 2021-2022 Appointed Officers of the Board as presented. MOTION CARRIED
MOTION 2021.03.20.02 (SABBADINI): Move to accept the 2021-2022 special (ad hoc) Committees of the Board as presented. MOTION CARRIED
MOTION 2021.03.20.03 (GUIJON): Move to accept the 2021-2022 committee appointments as presented. MOTION CARRIED
CALIFORNIA SOCIETY OF PEDIATRIC DENTISTRY
CSPD LEADERSHIP
Full list of committee members is located at www.cspd.org.
OFFICERS
President: Dr. Gila Dorostkar
President-Elect: Dr. Thomas Tanbonliong
Vice President: Dr. Donald Schmitt
Secretary: Dr. Mitch Poiset
Treasurer: Dr. Gary Sabbadini
Immed. Past President: Dr. Nancy Hsieh
DIRECTORS
North (22): Dr. Natalie Vander Kam
North (22): Dr. Chanel McCreedy
North (23): Dr. Amber Nierode
North (23): Dr. Helen Mo
South (22): Dr. John Guijon
South (22): Dr. Dora Lee
South (23): Dr. Leslie Butler
South (23): Dr. Catherine Pham
APPOINTED OFFICERS
Managing Editor: Dr. MyLinh Ngo
Associate Editor: Dr. Angela Lee
Associate Editor: Dr. Chanel McCreedy
Website Editor: Dr. Steve Niethamer
Public Policy Advocate:
Dr. Natalie Mansour
EXECUTIVE DIRECTOR
Dr. Paul Reggiardo
WARREN BRANDLI LEADERSHIP INTERNS
Dr. Letitia Edwards (USC)
Dr. Imran Ahmed (UCLA)
Dr. Ida Gorshteyn (UCSF)
SANTOS CORTEZ GRADUATE STUDENT LEGISLATIVE ADVOCACY INTERNS
Dr. JoyAh Brooks (NYU Langone San Diego)
Dr. JungSoo Kim (UCSF)
CONTACTS & LIAISONS
AAPD District V (WSPD) Trustee:
Dr. Jonathon Lee
AAPD Liaison: Catherine Pham
WSPD Liaison: Catherine Pham
AAP California Chapters Coordinator:
Dr. Kim Nichelini
AAP CA Chapter 1 Liaison:
Dr. Kim Nichelini
AAP CA Chapter 2 Liaison:
Dr. Catherine Pham
AAP CA Chapter 3 Liaison:
Dr. Nicole LaMantia
AAP CA Chapter 4 Liaison:
Dr. John Guijon
Annual Meeting Sponsor Relations Liaison: Dr. Leslie Butler
California Dental Society of Anesthesiology Liaison:
Dr. Dave Rothman
CSPD Foundation Liaison:
Dr. Nancy Hsieh
Consultant – Legislative Affairs:
Dr. Santos Cortez
Consultant – Dental Board California:
Dr. Paul Reggiardo
CSPD VOTING MEMBERS TO THE WSPD BOARD OF TRUSTEES
Dr. Gila Dorostkar
Dr. Thomas Tanbonliong
Dr. Donald Schmitt
Dr. Catherine Pham
STAFF
Association Management Services: Smith Moore & Associates
CSPD Account Manager: Yelena Martynovskaya
CSPD Account Coordinator: Abi Hague
CALIFORNIA SOCIETY OF PEDIATRIC DENTISTRY
808 R Street, Suite 209 Sacramento, CA 95811